三期螺旋CT扫描、经动脉门静脉造影CT扫描及经肝动脉造影CT扫描对经动脉化学栓塞治疗肝细胞肝癌计划及其实施情况的影响

目的 探讨在制定不可切除的肝细胞肝癌患者的化学栓塞计划及其实施情况方面,采用CTAP联合CTHA检查是否较常规的THCT联合肝动脉DSA检查更有利、更有价值.材料和方法采用前瞻性研究方式,连续有49名患有不可切除的肝细胞肝癌患者进入本项研究.该49名患者的平均年龄为64.9岁.全部患者在施行TACE前的1个月内均接受了...

Combined CT during arterial portography and CT during hepatic arteriography in addition to triple-phase helical CT on the planning and the performance of transcatheter arterial chemoembolization of hepatocellular carcinoma

Objective To assess whether the combined computed tomography during arterial portography （CTAP） and CT during hepatic arteriograpby （CTHA） provides any additional benefit to the conventional triple-phase helical CT and DSA on treatment decisions involving selective ehemoembolization of unresectable hepafoeellular careinoma（HCCs）. Methods Forty-nine consecutive patients with confirmed or suspected unreseetable HCC were referred for chemoembolization. All of them had undergone conventional THCT within 1 month before chemoembolization and were examined with the combined CTAP and CTHA in addition to DSA before undergoing transcatheter arterial chemoembolization TACE on the treatment day. Preliminary plans for selective hepatic arterial ehemoemboLization were prepared according to the results of conventional THCT examination. When necessary , a final plan for chemoembobzation was formulated on the basis of the CTAP and CTHA findings. Results Compared with preprocedural diagnostic THCT examinations, combined CTAP and CTHA found more tumor lesions in 15 patients （30.6%）. The additional lesions were identified not only on CTAP and/or CTHA but also on DSA in 8 patients （53.3%）. In the rest 7 patients, most of the additional lesions were small satellite lesions （mean diameter： 1. 0 cm） adjacent to larger masses or nodules, and were in the same vascular distribution as the parent lesions. As a result, no patients＇ previously tormulated chemoembolization treatment plan based on the preprocedural diagnostic THCT examinations was changed due to CTAP and CTHA image findings. Conclusion Combined CTAP and CTHA findings have limited impact on chemoembolization treatment planning in patients with unresectable HCCs. CTHA can provide complementary information to the angiographic findings and is therefore helpful for superselective TACE of HCCs.